Salivary egf concentration in adults with reflux chronic laryngitis before and after treatment: preliminary results

Claudia Alessandra Eckley, Lilia da Silva Rios, Luiz Vicente Rizzo, Claudia Alessandra Eckley, Lilia da Silva Rios, Luiz Vicente Rizzo

Abstract

The Laryngopharyngeal Reflux (LPR) physiopathology is still unknown. The Epidermal Growth Factor (EGF) is a biologically active salivary protein that aids in the rapid regeneration of the oropharyngeal and upper digestive tract mucosas. Salivary deficiency of this protein in patients with LPR has been demonstrated in previous studies.

Aim: To compare salivary EGF concentration in patients with LPR before and after treatment.

Materials and methods: In this prospective study twelve patients with GERD and moderate LPR were studied. Whole saliva samples were collected before and after treatment and salivary EGF concentration was determined using a commercially available ELISA kit (Quantikine).

Results: There were eleven females and one male among the patients, the mean age was 49 years. The mean pre-treatment salivary EGF concentration was 2,867.6 pg/mL and the mean post treatment EGF concentration was 1,588.5 pg/mL. This difference was statistically significant (p=0.015).

Discussion and conclusions: Although salivary EGF concentrations are higher before LPR treatment, the concentration is still much lower than the mean salivary EGF concentration in normal individuals without LPR, which suggests a primary disorder of this defense factor in individuals with LPR.

Figures

Figure 1
Figure 1
Laryngopharyngeal reflux-caused-inflammatory process intensity scale, based on videolaryngoscopy signs (varies from zero to 28).
Figure 2
Figure 2
EGF salivary concentration mean values in the two study periods (pre and post treatment) with EGF salivary concentration average in a control population (without reflux).

References

    1. Cherry J, Margulies SI. Contact ulcer of the larynx. Laryngoscope. 1968;78:1937–1940.
    1. Katz PO. Ambulatory esophageal and hypopharyngeal pH monitoring in patients with hoarseness. Am J Gastroenterol. 1990;85(1):38–40.
    1. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD):a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101(Suppl):1–78.
    1. Deveney CW, Benner K, Cohen J. Gastroesophageal reflux and laryngeal disease. Arch Surg. 1993;128:1021–1026.
    1. Paterson WG, Murat BW. Combined Ambulatory Esophageal Manometry and Dual-Probe pH-Metry in Evaluation of Patients with Chronic Unexplained Cough. Dig Dis Sci. 1994;39(5):1117–1125.
    1. Fraser AG. Review article: gastro-oesophageal reflux and laryngeal symptoms. Aliment Pharmacol Ther. 1994;8:265–272.
    1. Koufman JA, Cummins, MM. The prevalence and spectrum of reflux in laryngology:a prospective study of 132 consecutive patients with laryngeal and voice disorders. August 23, 1994. Available Internet < and . Center for Voice Disorders homepage> [Jan. 20, 2001]
    1. Waring JP, Lacayo L, Hunter J, Katz E, Suwak B. Chronic cough and hoarseness in patients with severe gastroesophageal reflux disease. Diagnosis and response to therapy. Dig Dis Sci. 1995;40(5):1093–1097.
    1. Costa HO, Eckley CA, Fernandes AMF, Destailleur D, Villela PH. Refluxo gastroesofágico: comparação entre os achados laríngeos e digestivos. Rev Port ORL. 1997;35(1):21–26.
    1. Shaw GY, Searl JP. Laryngeal Manifestations of Gastroesophageal Reflux before and after Treatment with Omeprazole. S Med J. 1997;90(11):1115–1122.
    1. Eckley CA, Marinho V, Ruiz WS, Costa HO. O uso da pH-metria esofágica de dois canais no diagnóstico da laringite crônica por refluxo gastroesofágico. Rev Bras ORL. 1999;66(2):110–114.
    1. Johanson JF. Epidemiology of esophageal and supraesophageal injuries. Am J Med. 2000;108(4A):99S–103S.
    1. Cianci R, et al. Is the alkaline reflux a risk factor for laryngeal lesions? Am J Gastroenterol. 2000;95(9):2398. (CARTA)
    1. Hanson DG, Jiang JJ. Diagnosis and management of chronic laryngitis associated with reflux. Am J Med. 2000;108(4A):112S–119S.
    1. Eckley CA. Estudo da concentração salivar do fator de crescimento epidérmico em indivíduos com laringite crônica por refluxo laringofaríngeo. São Paulo, 2002. (Tese - Doutorado - Faculdade de Ciências Médicas da Santa Casa de São Paulo).
    1. Eckley CA, Costa HO. Estudo da concentração salivar do fator de crescimento epidérmico em indivíduos com laringite crônica por refluxo laringofaríngeo. Rev Bras ORL. 2003;69(5):590–597.
    1. Gavazzoni FB, De Ataíde AL, Herrero Junior F, Macedo Filho ED. Esofagite por refluxo e laringite por refluxo: estágios clínicos diferentes da mesma doença? Rev Bras ORL. 2002;68(1):86–90.
    1. García-Compéan D, Gonzalez GG, Mar DA, Trevino RM, Bosques F, Maldonado H. Prevalence of gastroesophageal reflux disease in patients with extraesophageal symptoms referred from otolaryngology, allergy, and cardiology practices:a prospective study. Dig Dis. 2000;18:178–182.
    1. Kulig M, et al. Quality of life in patients with gastroesophageal reflux disease. Abstracts of the Digestive Disease Week. 2002;S1278:A-253.
    1. Helm JF, et al. Acid neutralizing capacity of human saliva. Gastroenterol. 1982;83:69–74.
    1. Helm JF, Dodds WJ, Hogan WJ. Salivary response to esophageal acid in normal subjects and patients with reflux esophagitis. Gastroenterol. 1987;93:1393–1397.
    1. Li L, et al. Effect of esophageal intraluminal mechanical and chemical stressors on salivary epidermal growth factor in humans. Am J Gastroenterol. 1993;88(10):1749–1755.
    1. Tobey NA. How Does the Esophageal Epithelium Maintain its Integrity? Digestion. 1995;56(Suppl. 1):45–50.
    1. Sarosiek J, Mccallum RW. Do salivary Organic Components Play a Protective Role in Health and Disease of the Esophageal Mucosa? Digestion. 1995;56(Suppl. 1):32–37.
    1. Marcinkiewicz M, Grabowska SZ, Czyzewska E. Role of Epidermal Growth Factor (EGF) in Oesophageal Mucosal Integrity. Curr Med Res Opin. 1998;14(3):145–153.
    1. Marcinkiewicz M, et al. The Potential Role of the Esophageal Pre-Epithelial Barrier Components in the Maintenance of Integrity of the Esophageal Mucosa in Patients with Endoscopically Negative Gastroesophageal Reflux Disease. Am J Gastroenterol. 2000;95(7):1652–1660.
    1. Eckley CA, Michelsohn N, Tadakoro CE, Rizzo LV, Costa HO. Salivary EGF concentration in adults with reflux laryngitis. Otolaryngol Head & Neck Surg. 2004;131(4):401–406.
    1. Dawes C. Circadian rythms in human salivary flow rate and composition. J Physiol. 1972;220:529–545.
    1. Sonnenberg A, et al. Salivary Secretion in Reflux Esophagitis. Gastroenterol. 1982;83:889–895.
    1. Belfasky PC, Postma GN, Koufman JA. The validity and reliability of the Reflux Finding Score (RFS). Laryngoscope. 2001;111(8):1313–1317.
    1. Moraes-Filho JPP, et al. Brazilian consensus on gastroesophageal reflux disease: proposals for assessment, classification, and management. Am J Gastroenterol. 2002;97(2):241–248.
    1. Koufman JA, Aviv JE, Casiano RR, Shaw GY. Laryngopharyngeal Reflux: Position statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology, Head and Neck Surgery. Otolaryngol Head Neck Surg. 2002;127(1):32–35.
    1. Jaspersen D, et al. Prevalence of extra-esophageal manifestations of gastroesophageal reflux disease: an analysis based on the ProGERD Study. Aliment Pharmacol Ther. 2003;17:1515–1520.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する